Femoral neuropathy following a psoas hitch vesicopexy

Caspar Müller*, Elvira Esmeralda Van Houwelingen, Frank Huygen

*Corresponding author for this work

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A 68-year-old man classified as III on the American Society of Anaesthesiologists (ASA) physical status classification system, with a high-grade papillary urothelial cell carcinoma of the left distal ureter, underwent open retroperitoneal distal ureterectomy followed by a ureteroneocystostomy with a vesico-psoas hitch. Postoperatively, the patient complained of left proximal lower limb weakness, severe pain and hypaesthesia of the ventral left thigh suggestive of femoral neuropathy. After excluding common causes for postsurgical pain, a surgical re-exploration was eventually performed during which the sutures used in the vesicopexy were removed, resulting in almost complete resolution of the symptoms. Electromyographic analysis 4 weeks after discharge confirmed the diagnosis of femoral neuropathy, most likely caused by the sutures used in the vesicopexy. This is a rare complication with major consequences for postoperative recovery.

Original languageEnglish
Article number225158
JournalBMJ Case Reports
Publication statusPublished - 2018

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© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.


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